Small group insurance requirements for employers

It’s been nearly 13 years since the Affordable Care Act (ACA), known formally as the Patient Protection and Affordable Care Act and informally referred to as Obamacare, took effect.

A landmark US federal act enacted by the 111th US Congress and signed into law by President Barack Obama on March 23, 2010, has changed health care coverage in many ways here in the United States

Together with the Health Care and Education Reconciliation Act of 2010, the ACA represents the most significant health care regulatory reform and expansion of coverage since the enactment of Medicare and Medicaid in 1965.

More than a decade later, business owners are more familiar with the ins and outs of ACA requirements for employers. In addition, in that period, many states have added or made changes to their own approach to affordable health care.

However, small business and business owners may still have many questions about what is required of them and what is not.

What is an ACA and how is small group insurance affected?

Perhaps the best way to define the Affordable Care Act is simply to defer to the description provided by the US Department of Health and Human Services web site entry:

The Patient Protection and Affordable Care Act, referred to as the Affordable Care Act or “ACA” for short, is a comprehensive health care reform law that was enacted in March 2010.

The law has three main objectives:

  • Making health insurance accessible to more people. The Act provides consumers with subsidies (“tax premium credits”) that reduce costs for families with incomes between 100% and 400% of the Federal Poverty Level (FPL).
  • Expand Medicaid to all adults whose income is less than 138% of the FPL. Not all states have expanded their Medicaid programs.
  • Supporting innovative medical care delivery approaches designed to reduce overall health care costs. “

What is commonly known as the employer’s mandate is of particular importance to business owners.

Simply put, this requirement mandates that employers with 50 or more full-time workers or equivalents (FTEs) must offer affordable health insurance that provides a minimum value to 95 percent of their full-time employees and their children through the end of the month in which they turn 26. years or be subject to penalties.

However, for employers with 49 or fewer full-time workers or the equivalent Not Required to offer health insurance options to its employees. In fact, it is advertiser On the website,

“No small business owner, generally those with fewer than 50 regular or full-time employees, is subject to an employer shared liability payment, regardless of whether they offer health insurance for their employees.”

However, many so-called “small businesses” would like to do this medical insurance Show interest although this is not a requirement.

To this end, the ACA created the Small Business Health Options Program (a store) for small employers who want to provide health and dental coverage for their employees.

Small Business Owners and Small Group Health Coverage

In general, most small businesses (and nonprofits) with fewer than 50 employees can use the Small Business Health Options Program, or SHOP, to purchase health coverage.

within Other benefitsEnrolling in SHOP insurance may allow you to get the Small Business Health Care Tax Credit. Your company may qualify if you have fewer than 25 full-time employees (FTEs) who earn an average annual salary of about $56,000 or less.

So, what are the requirements to register your small business in SHOP?

To enroll, purchase, and provide health insurance for the Small Business Health Options Program (SHOP) in addition to dental insurance for your employees, your business or nonprofit must meet these four requirements:

  1. It has 1-50 full time employees (FTEs)

To qualify for a SHOP, you must have at least one full-time equivalent employee other than the owners, spouses, family members of the owners, and partners.

  1. Offer coverage to all full-time employees

Full-time employees generally work 30 or more hours per week. Employees who average less than 30 hours per week are considered part-time. You do not have to offer coverage to part-time or seasonal workers but you can offer coverage to part-time employees if you choose.

  1. At least 70 percent of the employees to whom insurance is provided are enrolled

Some states have different minimum participation requirements (MPR). You do not have to meet minimum requirements to participate between November 15 and December 15, or Open the recording, during any year. Note that employees with other health coverage do not count as “declining” your health coverage offer.

  1. You have an employee office or work location within the country whose store you want to use

One exception to these requirements is the number of employees that are counted for a Small Group Plan designation by individual states. Currently, California, Colorado, New York and Vermont have mandated that small group plans be defined as group insurance arrangements covering 100 or fewer enrollees.


The health coverage experts for your small group

JC Lewis Insurance A local, family owned business based in Sonoma County since 1979, our expert brokers offer small business insurance plans. Our mission has always been to provide expert advice and assistance to small business owners when it comes to group health insurance and group medical plans.

In addition, our company only offers small business health insurance plans from leading health insurance companies that are licensed to do business in the states in which we operate.

Not only are we a team of professional, experienced brokers, but we are also licensed and approved by each of these insurance companies to offer coverage to Small group of employers Plus complementary and prescription drug plans for seniors.

when you think about Buy health insurance For you and your employees, and possibly vision and dental coverage, you likely have many questions and concerns.


At JC Lewis Insurance Services, we are happy to answer all of your questions about health insurance coverage. And you can be confident that we will help you find the right solution.

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